Q: I am suffering from Idiopathic oromandibular dystonia. Is there any treatment available?

A:Idiopathic oromandibular dystonia can be treated by injecting Botulinum toxin in the dystonic muscles of mouth and jaw. This toxin is available commercially. The toxin causes relaxation of the dystonic muscles by affecting the neuromuscular transmission. However, two points need to be considered. Firstly, the injection can cause weakness (transient and short lasting) in the muscles, which may cause problems in eating. So the muscles to be injected need to be selected carefully. Secondly, the effects of the injection last for only 3 to 6 months. So the injections need to be repeated. This may be a limiting factor for many patients as the injections are costly (100 units of toxin cost around Rs 16,000). Despite these caveats, the injection may prove to be invaluable for patients who are severely affected by dystonia. Oral drug treatment exists but usually is ineffective in most of the patients. I advise you to consult a neurologist with interest in movement disorders and who is regularly giving Boitulinum injections to his/her patients.